Mesenteric venous thrombosis (MVT), an uncommon but important clinical enti
ty, is one possible cause of ischemia or infarction of the small intestine.
Diagnosis of this condition is sometimes difficult and treatment is often
delayed because patients usually present with nonspecific abdominal symptom
s. The hallmark is pain that is out of proportion to the physical findings.
We report two cases of MVT, where the patients initially presented with va
gue abdominal symptoms. Diagnosis was made on the basis of computed tomogra
phy of the abdomen showing thrombus within the superior mesenteric vein. A
search for a precipitating condition revealed no evidence of a hypercoagula
ble state, myeloproliferative disorder, or malignancy. These cases illustra
te well the nonspecific clinical presentation of MVT. A high index of suspi
cion, recognition of known risk factors, or a previous history of venous th
rombosis coupled with a history of nonspecific abdominal symptoms should al
ert clinicians to the possibility of MVT. Early diagnosis and prompt antico
agulation are the mainstay of therapy unless there are signs of peritonitis
that necessitate surgical resection of the infarcted bowel.